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For many women, the nearest abortion provider is hundreds of miles away

There's a clinic that's right in Kelsey's town of Sioux Falls, S.D., that performs abortions, but she still drove hours away to get one.

Back in 2015, she was going through a difficult time -- recently laid off, had to move suddenly, helping a close family member through some personal struggles -- when she found out she was also pregnant.

"I kind of knew right away that this was just not the time or place to have a child. I mentally wasn't ready, financially wasn't ready," she says. "The whole situation really wasn't very good."

When Kelsey decided to end her pregnancy, she found herself navigating a maze of legal restrictions, in a part of the country where providers are few and far between. NPR is not using her last name to protect her privacy.

South Dakota has a 72-hour waiting period for abortions and requires women to meet with their doctor in advance of the procedure. Kelsey, a nurse, had recently started a new job and couldn't take the time off to go to two appointments at the clinic in her city.

She was just a few weeks along, and it was important to her to end the pregnancy early.

"I just knew that I didn't want to wait on this too long," she says. "Everybody has their own feelings about what is appropriate for them to have an abortion ... how far they want to wait and things like that. I just knew I just wanted to do it."

She called several providers throughout the region, some hundreds of miles away, before she finally found an appointment in Minneapolis, about a four-hour drive away, on a day she happened to have off work.

Kelsey's story is similar to that of many women across the country, according to a report released Tuesday by the Guttmacher Institute, a reproductive health research organization that supports abortion rights.

The report, published in The Lancet Public Health, includes an analysis by Guttmacher researchers of the distances women must travel to obtain abortions in the United States. For 1 in 5 women, the report finds, the trip is more than 40 miles one way.